power. this is important why are we putting our heads in the ground and presenting like well of course, we have customers? i have challenge that. i challenge that. >> i think you get the sense of the commission and i think you get the sense of the public comments. and i think we are going to let unless somebody else has anything to say, i think we are ready to move on. okay? any other new business? all right, the meeting is adjourned.

when a resident of san francisco is looking for health care, you look in your neighborhood first. what is closest to you? if you come to a neighborhood health center or a clinic, you then have access it a system of care in the community health network. we are a system of care that was probably based on the family practice model, but it was really clear that there are special populations with special needs. the cole street clinic is a youth clinic in the heart of

the haight ashbury and they target youth. tom woodell takes care of many of the central city residents and they have great expertise in providing services for many of the homeless. potrero hill and southeast health centers are health centers in those particular communities that are family health centers, so they provide health care to patients across the age span. . >> many of our clients are working poor. they pay their taxes. they may run into a rough patch now and then and what we're able to provide is a bridge towards getting them back on their feet. the center averages about 14,000 visits a year in the health clinic alone. one of the areas that we specialize in is family medicine, but the additional focus of that is is to provide care to women and children.

women find out they're pregnant, we talk to them about the importance of getting good prenatal care which takes many visits. we initially will see them for their full physical to determine their base line health, and then enroll them in prenatal care which occurs over the next 9 months. group prenatal care is designed to give women the opportunity to bond during their pregnancy with other women that have similar due dates. our doctors here are family doctors. they are able to help these women deliver their babies at the hospital, at general hospital. we also have the wic program, which is a program that provides food vouchers for our families after they have their children, up to age 5 they are able to receive food vouchers to get milk and cereal for their children. >> it's for the city, not only our clinic, but the city. we have all our children in san francisco should have insurance

now because if they are low income enough, they get medical. if they actually have a little more assets, a little more income, they can get happy family. we do have family who come outside of our neighborhood to come on our clinic. one thing i learn from our clients, no matter how old they are, no matter how little english they know, they know how to get to chinatown, meaning they know how to get to our clinic. 85 percent of our staff is bilingual because we are serving many monolingual chinese patients. they can be child care providers so our clients can go out and work. >> we found more and more women of child bearing age come down

with cancer and they have kids and the kids were having a horrible time and parents were having a horrible time. how do parents tell their kids they may not be here? what we do is provide a place and the material and support and then they figure out their own truth, what it means to them. i see the behavior change in front of my eyes. maybe they have never been able to go out of boundaries, their lives have been so rigid to sort of expressing that makes tremendous changes. because we did what we did, it is now sort of a nationwide model. >> i think you would be surprised if you come to these clinics. many of them i think would be your neighbors if you knew that. often times we just don't discuss that. we treat husband and wife and they bring in their kids or we treat the grandparents and then the next generation. there are people who come in who need treatment for their heart disease or for their diabetes or their high blood

pressure or their cholesterol or their hepatitis b. we actually provide group medical visits and group education classes and meeting people who have similar chronic illnesses as you do really helps you understand that you are not alone in dealing with this. and it validates the experiences that you have and so you learn from each other. >> i think it's very important to try to be in tune with the needs of the community and a lot of our patients have -- a lot of our patients are actually immigrants who have a lot of competing priorities, family issues, child care issues, maybe not being able to find work or finding work and not being insured and health care sometimes isn't the top priority for them. we need to understand that so that we can help them take care of themselves physically and emotionally to deal with all

these other things. they also have to be working through with people living longer and living with more chronic conditions i think we're going to see more patients coming through. >> starting next year, every day 10,000 people will hit the age of 60 until 2020. . >> the needs of the patients that we see at kerr senior center often have to do with the consequences of long standing substance abuse and mental illness, linked to their chronic diseases. heart failure, hypertension, diabetes, cancer, stroke, those kinds of chronic illnesses. when you get them in your 30's and 40's and you have them into your aging process, you are not going to have a comfortable old age.

you are also seeing in terms of epidemics, an increase in alzheimer's and it is going to increase as the population increases. there are quite a few seniors who have mental health problems but they are also, the majority of seniors, who are hard-working, who had minimum wage jobs their whole lives, who paid social security. think about living on $889 a month in the city of san francisco needing to buy medication, one meal a day, hopefully, and health care. if we could provide health care early on we might prevent (inaudible) and people would be less likely to end up in the emergency room with a drastic outcome. we could actually provide prevention and health care to people who had no other way of getting health care, those without insurance, it might be more cost